Insulin resistance is a common health concern that is increasingly affecting millions of people worldwide. With rising cases of diabetes, obesity and prediabetes, having an understanding of insulin resistance has become more critical than ever.

In this blog, we will talk about what insulin resistance is, its causes, symptoms, and the treatment options available for those individuals diagnosed with insulin resistance. If you or a loved one could be at risk, read on and learn how to manage this condition, and with the help of our expert medical professionals at LIMARP, you can find a way to treat it effectively. 

What is Insulin Resistance?

Insulin resistance takes place when the body’s cells become less responsive to it, insulin is a hormone produced by the pancreas that aids in regulating blood sugar levels. Usually, it eases the uptake of glucose (sugar) into the cells, where it can be used as energy. However, when these cells become resistant the glucose can remain in the bloodstream, causing it to elevate blood sugar levels. 

After some time, this can cause prediabetes and eventually, type 2 diabetes if not treated adequately. Insulin resistance doesn’t just appear overnight it usually develops slowly, making it quite difficult to detect without going through specific tests. This calls attention to the importance of routine health checkups, especially for individuals who are at high risk. 

Causes of Insulin Resistance 

There is not a single cause factor for insulin resistance; instead, it is quite often that it is a result of various factors combined. Here are some of the most common:

• Genetics: If there are cases of diabetes in the family history or insulin resistance can drastically increase the risk. 
• Obesity: Overweight individuals typically carry excess fat around the abdomen, which is one of the main triggers for insulin resistance. 
• Inactivity or sedentary lifestyle: Sedentary lifestyle contributes to weight gain and reduces the body’s ability to use it efficiently. 
• Diet: A diet high in processed foods, sugars, and unhealthy fats can all worsen its sensitivity leading to resistance. 
• Hormonal Changes: Specific conditions such as polycystic ovary syndrome (PCOS) can disrupt hormones and increase insulin resistance.

Understanding these factors can help in getting a personalized treatment plan, specifically identifying areas of improvement in lifestyle, which can in turn boost its sensitivity.

Symptoms of Insulin Resistance 

The early stages of insulin resistance usually show no symptoms, which is why it can go unnoticed until it has progressed to prediabetes or type 2 diabetes. There are some subtle signs that can indicate if there is a change in insulin resistance being there: 

• Fatigue: A feeling of excessive tiredness, even after having enough rest. 
• Increased hunger:  The body will crave more food, but will not be able to efficiently use the glucose in the bloodstream.
• Weight gain:  Specifically around the midsection, without any drastic changes in diet or activity. 
• Dark Patches of skin: This condition called acanthosis nigricans, typically develops in the body folds like the neck or underarms. 

All of these symptoms should encourage anyone to consult a medical professional, who can run tests such as blood tests, including fasting blood sugar levels, and confirm a diagnosis.   

Why Insulin Resistance is a Concern

Insulin resistance is a precursor to many metabolic issues, most notably prediabetes, and type 2 diabetes. If left without treatment, the body needs to produce more and more to achieve the create the same effect, the pancreas will be overworking; this condition can lead to serious complications which can include: 

• Heart disease: The blood vessels can sustain damage because of the high levels of glucose and insulin in the blood.
• Kidney disease: Over time high blood sugar levels can cause serious damage to the kidneys. 
• Nerve damage: Also known as diabetic neuropathy, this can happen when blood sugar levels rise. 

Treatment Options for Insulin Resistance 

While there isn’t a perfect go-to treatment for insulin resistance, it can be treated with a combination of lifestyle changes and if needed, in some cases, medication which can help to efficiently manage the condition. The goal here is to enhance the body’s sensitivity, low blood sugar levels, and thus prevent the progress of the condition into prediabetes or full-on diabetes. 

Dietary Changes

Diet is one of the most effective methods to control insulin resistance. It is possible to reduce the intake of processed foods, sugars, and refined carbohydrates can drastically improve your body’s ability to respond to it. Focusing on the following can help improve your diet and overall health: 

• Whole grains: These can be quinoa, oats, and brown rice. 
• Healthy fats: The sources for this would be avocados, nuts, and olive oil. 
• Lean proteins: These can include fish, chicken, and plant-based options. 
• Keeping a low-carb diet: has also been shown to be especially effective in improving its sensitivity, as it forces the body to burn fat for energy, and can reduce the amount of glucose in the bloodstream. 

Exercise

Physical activity is one of the most powerful tools in fighting off insulin resistance. Exercise can help the muscles absorb glucose without needing it, and thus can reduce blood sugar levels and improve its sensitivity. Both resistance training and cardiovascular exercise have their benefits: 

• Resistance training: These exercises increase muscle mass, which can greatly help the body use it more efficiently. 
• Aerobic exercises: Such as walking, swimming, and cycling all of which can improve the sensitivity almost immediately after the activity. 

Doing at least 30 minutes of moderate exercise on most days of the week can greatly improve your health overall. 

Weight Loss

For individuals who are overweight or obese, losing even a small percentage of body weight about 5-10% can make a dramatic difference in improving sensitivity. Weight loss can help with prediabetes, as it can help in reducing the fat around the abdomen, which is very closely linked to this condition. Bariatric surgery such as highly safe and advanced methods such as those from LIMARP, are proven to be an effective option for people struggling with weight loss even if they are combining diet and exercise. 

Medication

In certain cases, lifestyle changes might just not be enough to manage this condition, and it may be necessary to take some medication. The most common type of medication that is prescribed is metformin, which can help lower blood sugar levels and improve the body’s response to insulin. Other medications like SGLT2 inhibitors and GLP-1 receptor agonists may also be prescribed but can vary depending on the patient’s condition. 

Prediabetes and Its Connection

If these levels are left untreated, it can lead to a condition called prediabetes. This condition is characterized by blood sugar levels that become higher than normal but not high enough to be diagnosed as diabetes. It is a warning sign though, as it can lead to the path of type 2 diabetes unless drastic and significant changes are made on time. 

Many individuals with prediabetes don’t experience symptoms, which can make it vital to take regular checkups, especially if at risk. The good news is that prediabetes can be reversed, as prediabetes with the right interventions and treatment plans as well as, focusing on lifestyle changes. 

Treatment at LIMARP

At LIMARP, we specialize in helping all patients who are managing this condition. We provide a combination of both medically supervised weight loss programs, specifically tailored for each individual and their specific case. Bariatric surgery in combination with personalized lifestyle counseling. If you’ve noticed that you are struggling with these conditions, weight, or prediabetes, our team of highly experienced and accredited professionals can create a custom treatment plan to meet your specific health needs. 

Bariatric surgery, especially for procedures such as a gastric bypass, can be dramatically effective for improving insulin sensitivity, reducing the constant need for taking medications, and helping patients take back control over their health and their lives. 

Taking Action Now Can Prevent Prediabetes

Insulin resistance can seem like something very overwhelming, but with the right knowledge and treatment, it’s a very managed condition and can also significantly reduce the risk of prediabetes or diabetes. Early detection is key to treating the condition effectively, whether it is through lifestyle changes, medications, or bariatric surgery. 

By addressing the root causes of prediabetes and insulin resistance, whether it is because of different factors such as weight gain, inactivity, or an inefficient or poor diet. There is still a chance to take back control and ensure that you can have a better life by improving your health, and a much better future ahead.

Contact LIMARP today to explore what treatment options we have available, from our team of experienced medical professionals. Our state-of-the-art facilities and medical team can help you achieve your health goals and aid you in taking the first step towards a healthier future. 

Contact

For more information about our treatments for insulin resistance or to schedule a consultation, contact LIMARP today. We can assist you with treatment plans and options to see which is more beneficial for you and your overall health goals. From medications, lifestyle changes, diets, and exercises, to more in-depth treatments or even procedures to treat prediabetes, diabetes, and insulin resistance. Together we can help you overcome these insulin resistance and prediabetes, and have a positive outcome to your health and thus a healthier life. 

Resources

If you would like to learn more about insulin resistance and prediabetes, you can try these links below which can help in giving you a better understanding of the condition, remember to seek medical advice once if you wish to go forward with treatment as a proper diagnosis by a medical professional is vital.

• American Diabetes Association
• National Institute of Diabetes and Digestive and Kidney Diseases

If you’ve been keeping an eye on diabetes treatments or weight loss solutions, you’ve likely heard of Ozempic. This medication has garnered attention not only for its effectiveness in managing blood sugar levels but also for its potential benefits in weight loss. But what exactly does Ozempic do? How long can you stay on it, and what are the possible downsides? Let’s dive into these questions and more.

What Does Ozempic Do for Diabetics?

Ozempic, known generically as semaglutide, is a medication designed to help manage type 2 diabetes. It works by mimicking a hormone in your body called GLP-1 (glucagon-like peptide-1). This hormone helps to regulate blood sugar levels by stimulating insulin secretion and inhibiting glucagon release.

When you take Ozempic, it helps your pancreas produce more insulin when your blood sugar levels are high, making it easier to keep your blood sugar in a healthy range.

But that’s not all. Ozempic also slows down the digestion process, which means that sugar from the food you eat is absorbed more slowly into your bloodstream. This dual action helps to prevent the spikes in blood sugar that are common after meals.

Delving Deeper: Ozempic Side Effects 

Ozempic has gained popularity not only for its efficacy in managing type 2 diabetes but also for its potential in aiding weight loss. However, like any medication, it’s essential to be aware of its potential side effects, modes of administration, and long-term use implications.

Ozempic Side Effects

While Ozempic is effective in controlling blood sugar levels, users should be aware of possible side effects. Common Ozempic side effects include nausea, vomiting, diarrhea, and constipation. These symptoms often subside as your body adjusts to the medication. However, more severe side effects can occur, such as pancreatitis, which presents with severe abdominal pain, nausea, and vomiting. Other serious side effects might include changes in vision and kidney problems. It’s crucial to discuss any persistent or severe side effects with your healthcare provider to ensure the medication is safe for you.

The Downside of Ozempic

Like any medication, Ozempic comes with potential side effects. Some common Ozempic side effects include nausea, vomiting, diarrhea, and constipation. These symptoms are usually mild and tend to improve over time as your body gets used to the medication.

However, there are some more serious side effects to be aware of, such as pancreatitis (inflammation of the pancreas), changes in vision, and kidney problems.

It’s important to talk to your doctor about any side effects you experience, especially if they are severe or don’t go away.

Another downside to consider is the cost. Ozempic can be expensive, especially if your insurance doesn’t cover it. It’s worth checking with your insurance provider to see what options are available to you.

How Long Can You Stay on Ozempic for diabetes?

Ozempic is designed for long-term use when having diabetes. As long as it continues to be effective in managing your blood sugar levels and you don’t experience any serious Ozempic side effects, you can stay on Ozempic indefinitely. However, regular check-ins with your healthcare provider are essential. They will monitor your progress and make any necessary adjustments to your treatment plan.

What Does Ozempic Do to Your Organs?

Ozempic’s primary target is the pancreas, where it stimulates insulin production. However, its effects are felt throughout the body. By slowing down the digestive process, it impacts the stomach and intestines. Additionally, because it helps to lower blood sugar levels, it can reduce the strain on your kidneys over time. There’s also evidence that Ozempic may have cardiovascular benefits, such as reducing the risk of heart attack and stroke in people with type 2 diabetes.

However, it’s important to note that Ozempic can potentially cause pancreatitis, a serious condition where the pancreas becomes inflamed. Symptoms of pancreatitis include severe stomach pain, nausea, and vomiting. If you experience these symptoms, it’s crucial to seek medical attention immediately.

Ozempic Weight Loss

One of the most talked-about benefits of Ozempic is its potential for weight loss. While Ozempic is not a weight loss medication per se, many people who take it for diabetes management find that they lose weight as a side benefit. This weight loss is likely due to a combination of factors, including reduced appetite and slower stomach emptying, which helps you feel fuller for longer.

In fact, Ozempic weight loss has been studied specifically in people without diabetes, and the results have been promising. Many participants in these studies experienced significant weight loss, which has led to growing interest in Ozempic as a weight loss aid. However, it’s important to use Ozempic under the guidance of a healthcare provider, as it is primarily a diabetes medication.

Ozempic Injection vs Ozempic Pills

Currently, Ozempic is available as an injection. The Ozempic injection is typically administered once a week, making it a convenient option for many people. There’s ongoing research into oral versions of semaglutide (the active ingredient in Ozempic), which could offer an alternative for those who prefer not to use injections. However, as of now, the injection form is the standard.

Ozempic offers a promising option for people with type 2 diabetes and those looking for an effective weight loss aid. It works by helping to regulate blood sugar levels and offering the added benefit of weight loss for many users. However, like any medication, it’s important to be aware of the potential side effects and to use it under the guidance of a healthcare provider.

There is ongoing research into developing oral versions of semaglutide (the active ingredient in Ozempic). Ozempic pills could offer an alternative for those who prefer not to take injections. However, as of now, the injection form remains the standard.

Contact Us to Learn More

If you’re considering Ozempic, talk to your doctor about whether it’s the right choice for you. And if you’re looking for support in managing your diabetes or achieving your weight loss goals, the team at LIMARP is here to help. With comprehensive treatment plans tailored to your individual needs, we’re committed to helping you achieve better health and well-being.

If you’re ready to take control of your health and diabetes, explore how Ozempic or other treatments can help you, contact LIMARP bariatric clinic in Tijuana, Mexico. Reach out online anytime or call us at (619) 270 88 23 to schedule your consultation and start your journey to better health today.

Diabetes is a chronic disease that affects the body, specifically the eyes, heart, kidneys, and nerves. This disease affects the processes of glucose, a type of sugar that serves as primary energy for the body. This condition is about how your body turns foods’ sugar into energy and around 422 million people worldwide have been diagnosed with diabetes[1]. When it comes to type 2 diabetes, this condition happens because of a problem in the way the body regulates and uses sugar as a fuel. This long-term condition results in too much sugar circulating in the blood and eventually, high blood sugar levels can lead to disorders of the circulatory, nervous and immune systems.

Patients from all different backgrounds arrive at LIMARP® because they’re looking to improve their quality of life and embark on a healthier path. Our multidisciplinary team, led by Dr. Liza María Pompa González, offers different health services to help you reach your weight goals and beat obesity: from diet and exercise plans, to psychological guidance and surgical intervention. 

If you have type 2 diabetes and want to know if you’re a candidate for surgery, it’s important that you schedule an appointment at our Tijuana clinic so that you have all the necessary information you need, as well as the top-rated care and attention by our specialists. 

In this article, we’ll talk more broadly about type 2 diabetes and the available surgeries a patient can undergo in order to treat it.

As always, we’d like to remind you that the information provided below is general and that all cases are different. If you recognize or are interested in any of the points mentioned, please schedule an appointment with a doctor so that they can determine the best treatment plan for you. Your health and safety is very important to us.

What is diabetes?

Also known as diabetes mellitus, this condition is known as a metabolic disorder that is characterized by high blood sugar (hyperglycemia) over a long period of time[2]. Diabetes presents itself when the pancreas is not producing enough insulin or when the body isn’t absorbing or properly responding to the amount of insulin that’s being produced. Insulin is the hormone responsible for helping glucose from food get into cells to be used for energy[3]. 

There are three different types of diabetes and each have different characteristics, as well as distinct causes:

• Type 1 diabetes: This type of diabetes results from failure of the pancreas to produce enough insulin due to loss of beta cells, which in turn is caused by an autoimmune response[4]. This type of diabetes is most common in children and young adults, but it can also develop during adulthood.
• Type 2 diabetes: The main cause for this type of diabetes is insulin resistance and although it’s more common in adults, the rise of obesity among children has also resulted in young people developing type 2 diabetes. 
• Gestational diabetes: It occurs when pregnant women develop high blood sugar levels, and although their levels lower once they’ve given birth, they’re still at risk of developing type 2 diabetes in later years[5].

Some of the symptoms a person with diabetes may experience are increased thirst and appetite, as well as frequent urination. These symptoms can be considered mild, but if it goes untreated, diabetes can cause serious health problems, such as ketoacidosis, hyperosmolar hyperglycemic state, and complications like cardiovascular disease, stroke, chronic kidney disease, foot ulcers, damage to the nerves, damage to the eyes, and cognitive impairment.

Type 2 diabetes

Now that we’ve learned more about the different types of diabetes, let’s concentrate on type 2 diabetes, its causes, risk factors, symptoms, and available treatment. As we have briefly mentioned, type 2 diabetes is a condition that occurs when the body doesn’t use insulin correctly.

According to the CDC[6], “more than 37 million Americans have diabetes (about 1 in 10), and approximately 90-95% of them have type 2 diabetes. Type 2 diabetes most often develops in people over age 45, but more and more children, teens, and young adults are also developing it.”

In order to better understand how type 2 diabetes affects the body, it’s important to learn more about the causes, symptoms, and risk factors. Also, a simple blood test is enough to be diagnosed with this condition. Type 2 diabetes is caused by several factors, including lifestyle factors and genes. If the patient is overweight, obese, or doesn’t partake in any physical activity at all, they’re more likely to develop type 2 diabetes. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference since extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. 

Insulin resistance, as well as genes and family history, can also cause type 2 diabetes[7]. It usually begins with insulin resistance and the body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise. Genes also can increase the risk of type 2 diabetes by increasing a person’s tendency to become overweight or have obesity.

Type 2 Diabetes and Surgery

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), obesity and type 2 diabetes are closely related conditions, both linked to problems with the body’s metabolism. The same changes that lead to weight loss after surgery can also lead to the remission of type 2 diabetes. Most importantly, patients with this disease should know that the body’s ability to use sugar in a healthy way can be regained with surgery. Before considering surgery, treatment for type 2 diabetes consists of lifestyle changes to stabilize blood sugar levels and prevent further damage to the body through blood sugar control. People with this type of diabetes may also be prescribed medication, sometimes in high doses, to keep blood sugar levels under control.

When it comes to treating type 2 diabetes with surgery, metabolic or bariatric surgery is the best answer. According to one study, nearly all individuals who have surgery to treat diabetes show improvement in their diabetes, sometimes as quickly as a few days after surgery[8]. They experience lower blood sugar levels, need less diabetes medications, and see an improvement in diabetes-related health problems.

Overall, 78% of patients experience remission thus eliminating the need for diabetes medications.

Surgery for type 2 diabetes performed today is among the best studied therapies in modern medicine. Metabolic surgery results in less food intake and decreased calories absorbed and in changes to the metabolism that affect intestinal hormones that regulate blood sugar control. Bariatric surgery reduces hunger, increases the sense of fullness after meals, and assists the body’s ability to achieve a healthy weight.

Bariatric surgery has been proven to be the most effective therapy for diabetes but also greatly improves obesity and other associated conditions.

So, how do we know when a patient with type 2 diabetes is a candidate for metabolic surgery?

If the patient has a BMI of 30 or greater, they may qualify and will need to be in constant communication with their doctor to ensure a successful procedure and recovery. While there are risks when it comes to any type of surgery, it’s more dangerous to leave type 2 diabetes unattended, especially if the surgery has the potential to save the patient’s life.

Types of Surgery for Type 2 Diabetes

Next, we’ll list the best types of surgery to treat type 2 diabetes. Remember that you must speak with your bariatric surgeon to ensure which procedure is best for you. 

Gastric Bypass:

This surgery alters the gastrointestinal tract allowing food to avoid most of the stomach and the upper portion of the small intestine. The operation results in significant weight loss, remission of type 2 diabetes in nearly 80% of patients, and improvement of diabetes in an additional 15%, allowing the patient to achieve and maintain a healthy weight. 

Gastric Sleeve:

The sleeve is a procedure that removes a portion of the stomach. The remaining stomach is narrow and provides a much smaller pouch for food. The surgery also changes the metabolism and hormones produced by the intestines. Over 60% of patients will have remission of their type 2 diabetes after sleeve gastrectomy.

Duodenal Switch:

The duodenal switch is a malabsorptive surgery performed far less frequently than the gastric bypass, sleeve gastrectomy or the adjustable gastric band due to the complexity of the procedure and the greater risk of complications. Studies find, however, that the operation is most effective in inducing early and sustained remission or improvement of T2DM.

Contact Us to Learn More

If you or someone you know has type 2 diabetes and are considering surgery, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1]  “Diabetes”.  https://www.who.int/health-topics/diabetes. (Accessed May 24, 2023).
• [2] “About diabetes”. https://web.archive.org/web/20140331094533/http://www.who.int/diabetes/action_online/basics/en/. (Accessed May 24, 2023).
• [3] “What is diabetes?”. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes. (Accessed May 24, 2023).
• [4] “Type 1 diabetes”. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011. (Accessed May 24, 2023).
• [5] “Gestational diabetes”. https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339. (Accessed May 24, 2023).
• [6] “Type 2 Diabetes”. https://www.cdc.gov/diabetes/basics/type2.html. (Accessed May 24, 2023).
• [7] “Symptoms & Causes of Diabetes”. https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes#type. (Accessed May 24, 2023).
• [8] “Surgery for Diabetes”. https://asmbs.org/patients/surgery-for-diabetes. (Accessed May 24, 2023).

Bariatric Surgery and Gestational Diabetes

One study published in The New England Journal of Medicine[6] found that women who underwent bariatric surgery prior to pregnancy had a lower risk of developing gestational diabetes compared to women who did not have surgery. The same study found that women who had bariatric surgery before pregnancy had a lower risk of certain pregnancy complications, including gestational diabetes.

It’s important to discuss your options with your doctor if you have gestational diabetes and are considering bariatric surgery after your delivery. They can help you determine the best course of action based on your individual health needs and the risks and benefits of different treatments. In most cases, managing gestational diabetes with a healthy diet, exercise, and medications as needed is the recommended approach during pregnancy. After pregnancy, bariatric surgery may be a viable option for weight loss and to reduce the risk of future health problems, including type 2 diabetes.

Gestational Diabetes Treatment

Although the treatment for this condition includes lifestyle changes (how you eat and move), blood sugar monitoring, and medication, once a woman has been diagnosed with gestational diabetes and for any reason she can’t follow the treatment, there might appear several potential effects on a woman’s health[7]. If left untreated, it can increase the risk of certain complications during pregnancy, including:

• Preeclampsia: This is a potentially life-threatening complication characterized by high blood pressure and damage to organs such as the liver and kidneys. Women with gestational diabetes are at a higher risk of developing preeclampsia.
• Cesarean delivery: Women with gestational diabetes may be more likely to require a cesarean delivery due to complications such as a large baby or difficulties during labor.
• Preterm birth: Gestational diabetes may increase the risk of preterm labor, leading to health problems for the baby.
• Future risk of type 2 diabetes: Women with gestational diabetes have a higher risk of developing type 2 diabetes later in life.

In conclusion, the treatment typically involves closely monitoring blood sugar levels, following a healthy diet and exercise plan, and, in some cases, taking insulin or other medications as prescribed by a doctor.

Psychology of Gestational Diabetes

The diagnosis of gestational diabetes can be emotionally challenging for many women. It can bring about feelings of guilt, anxiety[8], and stress, as well as concerns about the health of the baby and the potential for future health problems.

It is important to note that most women with gestational diabetes have healthy pregnancies and deliver healthy babies with proper medical care. Although, women with this condition might need to seek psychological support. 

Some common psychological effects of gestational diabetes include:

• Guilt and self-blame: Many women feel guilty and blame themselves for developing gestational diabetes, even though hormonal changes often cause it during pregnancy.
• Anxiety and stress: The diagnosis of gestational diabetes can be stressful and anxiety-provoking, as it requires significant lifestyle changes and may increase the risk of complications for the mother and baby.
• Fear for the baby’s health: Women with gestational diabetes may worry about the health and well-being of their baby, including the risk of preterm labor, macrosomia (a large baby), and stillbirth.
• Concerns about future health: Women with gestational diabetes may worry about the long-term health implications of the condition, including the risk of developing type 2 diabetes later in life.

Women with gestational diabetes need to seek emotional support and guidance from their healthcare providers, family, and friends. This can include counseling or therapy to help manage anxiety and stress, as well as support groups for women with gestational diabetes.

It’s also important for women with gestational diabetes to focus on self-care, including healthy eating, exercise, and self-monitoring of blood sugar levels. By taking an active role in their healthcare and managing their condition, women can feel empowered and confident in their ability to have a healthy pregnancy and deliver a healthy baby.

Suppose you have risk factors for gestational diabetes or have had the condition in a previous pregnancy. In that case, it’s important to talk to your doctor about ways to reduce your risk. By taking steps to prevent gestational diabetes, women can improve their health and reduce the risk of complications during pregnancy and delivery[9].

Contact Us to Learn More

If you want to learn more about gestational diabetes, its symptoms and how to prevent it, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References:

[1] “Diabetes Statistics”. https://diabetesresearch.org/diabetes-statistics/. (Accessed April 25, 2023).

[2, 3, 4, 7] “Gestational diabetes”. https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339. (Accessed April 25, 2023).

[5] “Gestational Diabetes”. https://www.cdc.gov/diabetes/basics/gestational.html. (Accessed April 25, 2023).

[6] “Outcomes of Pregnancy after Bariatric Surgery”. https://www.nejm.org/doi/full/10.1056/nejmoa1405789. (Accessed April 25, 2023).

[8, 9] OuYang H, Chen B, Abdulrahman AM, Li L, Wu N. Associations between Gestational Diabetes and Anxiety or Depression: A Systematic Review. J Diabetes Res. 2021 Jul 27;2021:9959779. doi: 10.1155/2021/9959779. PMID: 34368368; PMCID: PMC8337159.

Patients from all different backgrounds arrive at LIMARP® because they’re looking to improve their quality of life and embark on a healthier path. Our multidisciplinary team, led by Dr. Liza María Pompa González, offers different health services to help you reach your weight goals and beat obesity: from diet and exercise plans, to psychological guidance and surgical intervention.

Diabetes is a chronic disease that affects the body, specifically the eyes, heart, kidneys, and nerves. This disease affects the processes of glucose, a type of sugar that serves as primary energy for the body. This condition is about how your body turns foods’ sugar into energy and around 422 million people worldwide have been diagnosed with diabetes[1].

This condition presents severe risks for both the mother and the baby during pregnancy since it involves risks and complications. 

Although there are several types of diabetes, specialists can manage the risks and complications associated with diabetes during pregnancy with proper planning and medication.

This article will dive into each type of diabetes that can present itself throughout a pregnancy.

Keep in mind that the following information doesn’t necessarily apply to every case and that if you recognize any symptom, you must contact your doctor right away.

Types of Diabetes in Pregnancy

Several types of diabetes may occur during pregnancy, such as gestational diabetes[2], which is the type of diabetes that appears during pregnancy, usually in the second or third trimester. In some cases, this type of diabetes disappears after delivery. However, women who develop gestational diabetes during pregnancy are at higher risk of developing type 2 diabetes later in life.

Type 1 diabetes is different. It occurs when the body’s immune system attacks the cells that produce insulin in the pancreas, so the body cannot use blood sugar for energy. Insulin is the hormone that regulates blood sugar levels[3]. 

Type 2 diabetes, on the other hand, appears when the body resists insulin or when the pancreas does not produce enough insulin to maintain normal blood sugar levels. This means that with type 2 diabetes your body does not use insulin well and cannot keep blood sugar at normal levels[4].

During pregnancy, the woman’s body demands more insulin due to the growing fetus needing energy to develop. Women diagnosed with any type of diabetes will need regular appointments to manage their blood sugar levels throughout pregnancy. This may involve adjusting medication doses, monitoring blood sugar levels more frequently, and making lifestyle changes.

Therefore, women with gestational diabetes or diabetes type 1 and 2 can manage their condition by changing their way of living, such as eating a healthy diet and establishing an exercise routine. Some women may also need to monitor their blood sugar levels and take medication, such as insulin.

Diagnosis, Management, and Preconception Planning

Diabetes diagnosed during pregnancy involves pregnant women getting a glucose tolerance test. If diagnosed with diabetes during pregnancy, treatment and management will depend on the type of diabetes and the severity of the condition.

As previously mentioned, preconception planning is key when managing diabetes during pregnancy. Women planning to become pregnant should work with their doctor to optimize their blood sugar levels before becoming pregnant.

Insulin in pregnancy is an option with irregular blood levels, but it is imperative to visit a personal doctor to take the necessary precautions. This may involve adjusting medication doses or making lifestyle changes to have better blood sugar control.

Insulin in Pregnancy

Pregnant women may experience insulin resistance, making the body less responsive to insulin. Insulin resistance during pregnancy is a natural physiological process that allows glucose to be delivered to the growing fetus for its growth and development. However, in some cases, insulin resistance can become more severe, leading to gestational diabetes.

Managing insulin levels during pregnancy is vital for both the mother and the baby since high blood sugar levels can increase the risk of complications during pregnancy. In addition, poorly controlled blood sugar levels during pregnancy increase the baby’s risk of developing health problems, such as hypoglycemia (low blood sugar)[5] and respiratory distress syndrome (RDS).

Monitoring blood sugar levels and managing insulin levels through diet, exercise, and medication is crucial during pregnancy to ensure the health of both the mother and the baby.

Diabetes Risks Factors in Pregnancy

Diabetes during pregnancy is risky for both the mother and the baby if not treated. Some of the risks and complications associated with diabetes during pregnancy include:

• Macrosomia: A condition in which the baby grows too large, which can lead to complications during delivery. Besides causing discomfort to the woman during the last few months of pregnancy, an extra-large baby can lead to the mother needing a C-Section to deliver the baby. The baby can be born with nerve damage due to pressure on the shoulder during delivery[6].
• Pre-eclampsia or high blood pressure: Pregnant women may present signs of damage to other organs, such as the kidneys, liver, or brain. This circumstance might lead to the baby being born early and also could cause seizures or a stroke (a blood clot or a bleed in the brain that can lead to brain damage) in the woman during labor and delivery[7].
• Stillbirth or miscarriage: This is a serious complication that can happen when the baby dies in the womb after 20 weeks of gestation. A woman who has diabetes that is not well controlled has a higher chance of having a miscarriage or stillbirth.
• Birth defects: The organs of the baby form during the first two months of pregnancy, often before a woman knows that she is pregnant. Women with uncontrolled diabetes during pregnancy have higher risk of giving birth to a baby with birth defects, such as heart defects or neural tube defects.

Postpartum Care

Postpartum care is also essential for women with diabetes type 1, type 2, and gestational diabetes. The American College of Obstetrics and Gynecology (ACOG) and the American Diabetes Association (ADA) recommend that women with Gestational Diabetes receive care 6–12 weeks after delivery to assess blood pressure, body mass index (BMI), and metabolic profile, in addition to routine postpartum concerns[8]. As said before, women with gestational diabetes have a higher risk of developing type 2 diabetes later in life, so regular follow-up visits with their doctor are highly recommended to manage their condition after giving birth.

Gestational Diabetes Prevention

Although gestational diabetes is not always preventable, women can take action to reduce their risk of developing the condition during pregnancy[9]. Here are a few tips for its prevention:

• Keep a healthy weight: Being overweight or obese increases the risk of gestational diabetes. Women planning to become pregnant should aim to achieve a healthy weight before pregnancy and continue to maintain it throughout pregnancy.
• Eat a healthy diet: A balanced diet includes choosing foods that are low in sugar and refined carbohydrates and high in fiber, protein, and healthy fats. Eating regular meals and snacks is also important for stabilizing blood sugar levels.
• Exercise regularly: Regular physical activity that’s moderately intense, such as brisk walking, lowers your blood sugar and makes you more sensitive to insulin so your body won’t need as much. Make sure to check with your doctor about what kind of physical activity you can do and if there are any kinds you should avoid.
• Monitor blood sugar levels: Women who are at high risk for gestational diabetes need to monitor their blood sugar levels at home. This involves testing blood sugar levels several times a day using a glucose meter.

Bariatric Surgery and Diabetes

Research has shown that bariatric surgery can lead to remission of type 2 diabetes in many patients, meaning that their blood sugar levels return to normal without needing diabetes medication. This effect is most pronounced in people who have had diabetes for a shorter period and who have better blood sugar control before the surgery.

Surgical operations with intestinal diversion and mainly duodenal-jejunal exclusion have consistently shown beneficial effects on glucose homeostasis by reducing insulin resistance and increasing insulin secretion[10].

In summary, bariatric surgery can help with diabetes by inducing weight loss, improving insulin sensitivity and glucose regulation, and leading to remission of type 2 diabetes in some patients. However, bariatric surgery is a major surgical procedure with potential risks and complications, and it should only be considered after careful evaluation and discussion with a qualified healthcare provider.

Contact Us to Learn More

If you want more information about diabetes and pregnancy, risks and complications, or diabetes related to bariatric surgery, schedule an appointment with us. We can help determine the right treatment for you. Contact us online anytime or call us at (619) 373-0229.

References

• [1]  “Diabetes”.  https://www.who.int/health-topics/diabetes. (Accessed April 24, 2023). 
• [2] “Pregnancy if You Have Diabetes”. https://www.niddk.nih.gov/health-information/diabetes/diabetes-pregnancy. (Accessed April 24, 2023). 
• [3] “An overview of insulin”. https://www.medicalnewstoday.com/articles/323760. (Accessed April 24, 2023).
• [4] “What is Diabetes?”. https://www.cdc.gov/diabetes/basics/diabetes.html. (Accessed April 24, 2023).
• [5, 7] “Type 1 or Type 2 Diabetes and Pregnancy”. https://www.cdc.gov/pregnancy/diabetes-types.html. (Accessed April 24, 2023).
• [6] “Diabetes and Pregnancy”. https://www.cdc.gov/pregnancy/diabetes.html. (Accessed April 24, 2023). 
• [8] Martinez NG, Niznik CM, Yee LM. Optimizing postpartum care for the patient with gestational diabetes mellitus. Am J Obstet Gynecol. 2017 Sep;217(3):314-321. doi: 10.1016/j.ajog.2017.04.033. Epub 2017 Apr 26. PMID: 28455081; PMCID: PMC5581263. 
• [9] “Gestational Diabetes”. https://www.cdc.gov/diabetes/basics/gestational.html. (Accessed April 24, 2023).  
• [10] Koliaki C, Liatis S, le Roux CW, Kokkinos A. The role of bariatric surgery to treat diabetes: current challenges and perspectives. BMC Endocr Disord. 2017 Aug 10;17(1):50. doi: 10.1186/s12902-017-0202-6. PMID: 28797248; PMCID: PMC5553790.

Health should always be a top priority, from the access people have to proper care and information to the steps one must take in order to lead a healthy lifestyle. There are several factors that can improve or worsen a person’s health; some of them can be managed or course corrected by making significant changes to their diet, while others can be treated with controlled or prescribed medication. Whichever the case may be, it’s always important to be mindful of how well we take care of our bodies and mind. 

However, we also understand that lifestyle changes may not be enough and that without proper health care, a condition can worsen and even give way to the development of others. This is most commonly seen with people who are struggling with obesity, as they tend to be more at risk of comorbidities, such as diabetes, sleep apnea, heart diseases, and osteoarthritis.

Obesity affects everyone around the world with data suggesting that “the number of obese people in the world has tripled since 1975 to roughly 30% of the total population”[1], and this number continues to rise.

Just as there are many causes for obesity, there are also many consequences that may arise if a person is battling with extra weight. This disorder is one of the leading causes of death because it dramatically decreases a person’s life expectancy. 

Patients from all different backgrounds arrive at LIMARP® because they’re looking to improve their quality of life and embark on a healthier path. Our multidisciplinary team, led by Dr. Liza María Pompa González, offers different health services to help you reach your weight goals and beat obesity: from diet and exercise plans, to psychological guidance and surgical intervention. 

For this article, we will talk about diabetes and incontinence, the link that exists between these conditions, and the available treatments.

The information we’ll present is general and illustrative, so it may not apply to every specific case; if you have diabetes, incontinence, or both, be sure to talk with your doctor before embarking on a new treatment or leaving an old one behind.

What is diabetes?

Also known as diabetes mellitus, this condition is known as a metabolic disorder that is characterized by high blood sugar (hyperglycemia) over a long period of time[2]. Diabetes presents itself when the pancreas is not producing enough insulin or when the body isn’t absorbing or properly responding to the amount of insulin that’s being produced. Insulin is the hormone responsible for helping glucose from food get into cells to be used for energy[3]. 

There are three different types of diabetes and each have different characteristics, as well as distinct causes:

• Type 1 diabetes: This type of diabetes results from failure of the pancreas to produce enough insulin due to loss of beta cells, which in turn is caused by an autoimmune response[4]. This type of diabetes is most common in children and young adults, but it can also develop during adulthood.
• Type 2 diabetes: The main cause for this type of diabetes is insulin resistance and although it’s more common in adults, the rise of obesity among children has also resulted in young people developing type 2 diabetes. 
• Gestational diabetes: It occurs when pregnant women develop high blood sugar levels, and although their levels lower once they’ve given birth, they’re still at risk of developing type 2 diabetes in later years[5].

Some of the symptoms a person with diabetes may experience are increased thirst and appetite, as well as frequent urination. These symptoms can be considered mild, but if it goes untreated, diabetes can cause serious health problems, such as ketoacidosis, hyperosmolar hyperglycemic state, and complications like cardiovascular disease, stroke, chronic kidney disease, foot ulcers, damage to the nerves, damage to the eyes, and cognitive impairment.

Another link that’s being explored, including by us in this article, is the one that exists between diabetes and incontinence. But before we dive in, let’s talk about incontinence. Urinary incontinence happens when a person leaks urine by accident. Also known as overactive bladder, it is more common in older people, especially women[6]. There are many reasons why a person can develop incontinence, for example: including urinary tract infections (UTI), vaginal infection or irritation, or constipation. Other reasons for long-lasting incontinence include:

• Weak pelvic floor muscles
• Overactive bladder muscles
• Arthritis
• Pelvic organ prolapse
• Multiple sclerosis, diabetes, or Parkinson’s disease

As you can see, diabetes can cause incontinence and this is due to the damage done to the nerves that control the bladder. So, now that we have learned the basics about incontinence, let’s move on to how this condition is related to diabetes, how to prevent it, and the available treatments. 

The link between diabetes and incontinence

While having diabetes or incontinence doesn’t guarantee you’ll develop the other, there is a chance that if you’re struggling with diabetes, you’re more at risk of developing incontinence.

A study[7] found that 39% of the women with diabetes they tested have incontinence, while another journal[8] published that incontinence may worsen if the patient also has type 2 diabetes.

There is no clear explanation for the appearance of incontinence once you’ve developed any type of diabetes, but there are different ways it can contribute. The first is that obesity, which can lead to type 2 diabetes, puts pressure on the bladder due to the excess body fat; another one, which have previously mentioned, is the damage done to the nerves that control the bladder; a compromised immune system can also increase the risk for urinary tract infections; lastly, some diabetes medication can cause diarrhea or involuntary leakage. 

Other reasons why having diabetes can increase the risk of developing incontinence is due to the fact that high blood sugar levels seen with diabetes can cause you to become thirstier and urinate more. It’s also important to point out that women with diabetes are more at risk than men of having urinary incontinence because factors like childbirth and UTIs are more common amongst women.

It’s also possible for people to experience nocturia, the need to urinate more than once during the night, which can be a sign of uncontrolled blood sugar levels or a urinary tract infection[9]. Another study pointed out that if a person is diabetic and also has a high BMI, they’re at more risk of a higher intrapelvic pressure, which can lead to urinary incontinence[10]. The pressure that the extra weight has on the lower abdomen can lead to a type of urinary incontinence known as stress incontinence, which is characterized by bladder leakage when a person coughs, laughs, sneezes, or is physically active. 

The nerve damage that diabetes causes on the bladder is known as neuropathy and it can also cause a neurogenic or diabetic bladder, which is partial or full loss of bladder control. This also impacts the bowels, thus leading to urinary and fecal incontinence. 

Available treatments

The treatment, of course, depends on the case of each patient and their symptoms. Be sure to contact your doctor if your current treatment, either for diabetes or incontinence, is worsening your symptoms. They can recommend different medications or antibiotics if you have a UTI; they may also suggest lifestyle changes, such as modifying your diet by adding more fiber-heavy foods to help with regulating bowel movements and reducing constipation. 

Keeping your blood sugar levels regulated can prevent more nerve damage to the bladder or reduce the risk of developing incontinence in the first place. Your doctor may also suggest weight loss if the reason for your incontinence is a high abdominal BMI or obesity; the loss of weight not only will improve the symptoms of incontinence, but allow you to live a healthier lifestyle, not only because it will lower your risk of developing other conditions that come with obesity or being overweight, but because it can also help lower any complications related to diabetes.

Contact Us to Learn More

If you want to learn more about diabetes and incontinence, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1] “Most Obese Countries 2022”. https://worldpopulationreview.com/country-rankings/most-obese-countries. (Accessed September 28, 2022).
• [2] “About diabetes”. https://web.archive.org/web/20140331094533/http://www.who.int/diabetes/action_online/basics/en/. (Accessed September 28, 2022).
• [3] “What is diabetes?”. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes. (Accessed September 28, 2022).
• [4] “Type 1 diabetes”. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011. (Accessed September 28, 2022).
• [5] “Gestational diabetes”. https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339. (Accessed September 28, 2022).
• [6] “Urinary Incontinence in Older Adults”. https://www.nia.nih.gov/health/urinary-incontinence-older-adults. (Accessed September 28, 2022).
• [7] Ebbesen MH, Hannestad YS, Midthjell K, Hunskaar S. Diabetes and urinary incontinence − prevalence data from Norway. Acta Obstet Gynecol Scand. 2007 Oct;86(10):1256-62. doi: 10.1080/00016340701625347. PMID: 17851814.
• [8] “Type 2 Diabetes Mellitus and Risk of Stress, Urge and Mixed Urinary Incontinence”. https://www.auajournals.org/doi/full/10.1016/j.juro.2008.09.007. (Accessed September 28, 2022).
• [9] “Diabetes And Incontinence”. https://www.bladderandbowel.org/associated-illness/diabetes-incontinence/#:~:text=Can%20Diabetes%20Cause%20Incontinence%3F,are%20not%20bought%20under%20control. (Accessed September 28, 2022).
• [10] Izci Y, Topsever P, Filiz TM, Cinar ND, Uludağ C, Lagro-Janssen T. The association between diabetes mellitus and urinary incontinence in adult women. Int Urogynecol J Pelvic Floor Dysfunct. 2009 Aug;20(8):947-52. doi: 10.1007/s00192-009-0888-8. Epub 2009 Apr 30. PMID: 19404561; PMCID: PMC2706373.